Fecal impaction is a severe form of constipation where a hard, dry mass of stool becomes lodged in the rectum or colon. This blockage prevents normal stool passage and leads to waste buildup. It requires prompt attention, as it will not resolve on its own.
Recognizing the Signs
An inability to pass stool is a primary indicator of fecal impaction. This prolonged lack of bowel movements often accompanies severe abdominal pain and cramping from accumulated waste. The abdomen might appear bloated and distended due to this pressure.
Individuals with impacted stool often experience nausea and vomiting as the body tries to expel blocked contents. A loss of appetite can also occur, contributing to a general feeling of being unwell. Despite a strong urge to have a bowel movement, there is little to no success when straining.
A common, yet confusing, symptom is the passing of small amounts of liquid stool or mucus, sometimes referred to as overflow diarrhea. This happens when liquid stool from higher up in the colon leaks around the hardened blockage. Rectal discomfort or pain is common, along with a persistent feeling of fullness in the rectum, even after attempts to pass stool.
Common Causes
Chronic constipation is the most frequent precursor to fecal impaction, as untreated constipation allows stool to harden and accumulate. A diet low in fiber, which helps add bulk to stool, and insufficient fluid intake can contribute to the stool becoming dry and difficult to pass. A lack of physical activity or prolonged immobility also slows down the movement of stool through the intestines.
Certain medications are known to cause constipation as a side effect, increasing the risk of impaction. These include opioid pain relievers, some antidepressants, iron supplements, and certain blood pressure medications like calcium channel blockers. Ignoring the natural urge to have a bowel movement can also lead to stool hardening in the rectum, making it more challenging to pass.
Underlying medical conditions can also predispose individuals to fecal impaction. These include neurological conditions such as Parkinson’s disease or spinal cord injury, which can disrupt nerve signals to the bowel. Conditions like diabetes and hypothyroidism can also slow down intestinal motility, increasing the risk of severe constipation and impaction. Structural issues in the colon or rectum, though less common, can impede stool passage.
When to Seek Medical Attention
Fecal impaction typically requires medical intervention and should not be ignored or self-treated for extended periods. Seek prompt medical attention if you suspect you have impacted stool. Delaying treatment can lead to complications such as ulcers, inflammation of the colon (colitis), or even a bowel obstruction.
Certain symptoms warrant immediate medical attention or an emergency room visit. These “red flag” signs include severe, worsening abdominal pain, persistent vomiting, or a fever. Rectal bleeding or signs of dehydration also warrant urgent medical evaluation.
Confusion or lethargy, particularly in older individuals, can be a sign of severe complications related to fecal impaction. These symptoms suggest dangers like a bowel perforation or systemic issues that require immediate professional care. Addressing these signs quickly can prevent serious outcomes.
What to Expect at the Doctor’s Office
Upon visiting the doctor for suspected fecal impaction, the process typically begins with a detailed discussion of your medical history and current symptoms. The doctor will ask about your bowel habits, diet, and any medications you are currently taking. This helps in understanding the potential causes and severity of your condition.
A physical examination will follow, which includes palpating or gently pressing on your abdomen to feel for any hardened masses or areas of tenderness. This helps the doctor locate the affected parts of your digestive system. A digital rectal examination (DRE) is a common diagnostic tool where the doctor inserts a gloved, lubricated finger into the rectum to feel for the presence of a hardened stool mass.
While a DRE can confirm an impaction in the rectum, further imaging might be necessary if the blockage is suspected higher in the colon. An abdominal X-ray can confirm the presence and location of the impaction within the intestines. The doctor will then discuss appropriate treatment options based on the severity and location of the impaction.